Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
INSJ STABLJ DEV W/O DCMPRN
Sacramento, CA
See all hospitals reporting CPT 22869 →Price type
Dignity Community Care’s median price of $11.5k is 10% below the median hospital's median price ($12.8k), higher than 37% of the 1,495 hospitals reporting CPT 22869. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 18 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | UnitedHealthcare medicaid|< 21 fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 2 | UnitedHealthcare medicaid|> 21 fee schedule · outpatient | $468 | $468 | — | — | — | $468 – $468 |
| 3 | Molina medicaid|all plans fee schedule · outpatient | $881 | $881 | — | — | — | $881 – $881 |
| 4 | Anthem medicaid|all plans fee schedule · outpatient | $890 | $890 | — | — | — | $890 – $890 |
| 5 | Aetna commercial|all other plans case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 6 | Aetna commercial|hmo case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 7 | Aetna commercial|ppo case rate · outpatient | $7.8k | $7.8k | — | — | — | $7.8k – $7.8k |
| 8 | Anthem commercial|connection epo case rate · outpatient | $10.2k | $10.2k | — | — | — | $10.2k – $10.2k |
| 9 | Anthem commercial|all other plans case rate · outpatient | $12.8k | $12.8k | — | — | — | $12.8k – $12.8k |
| 10 | Anthem medicare|all other plans fee schedule · outpatient | $15.9k | $15.9k | — | — | — | $15.9k – $15.9k |
| 11 | Aetna medicare|all plans fee schedule · outpatient | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 12 | Blue Cross Blue Shield medicare|all plans case rate · outpatient | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 13 | Humana commercial|all plans fee schedule · outpatient | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 14 | Humana medicare|all plans fee schedule · outpatient | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 15 | Kaiser medicare|all plans fee schedule · outpatient | $16.9k | $16.9k | — | — | — | $16.9k – $16.9k |
| 16 | Anthem commercial|mcs case rate · outpatient | $17.0k | $17.0k | — | — | — | $17.0k – $17.0k |
| 17 | UnitedHealthcare medicare|all plans fee schedule · outpatient | $17.2k | $17.2k | — | — | — | $17.2k – $17.2k |
| 18 | Anthem medicare|imperial fee schedule · outpatient | $17.4k | $17.4k | — | — | — | $17.4k – $17.4k |
Last updated: Feb 28, 2026
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